In children with EHBA, malnutrition adversely affects outcome. Our goal is to test the hypothesis that treatment with IGF-1 will promote nitrogen retention in children with EHBA awaiting liver transplantation. We will assess the effect of short-term IGF-1 treatment on nitrogen retention in children with EHBA and persistent cholestasis. The information gained will provide preliminary data for a study designed to assess the effect of IGF-1 treatment on outcome in children with EHBA who undergo liver transplantation.